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Pharmacology General cf620863

If a thiazide diuretic is administered for hypertension, the response seen within 24 hrs on the excretion of different electrolytes are:

A
Sodium(Upward arrow) Potassium (Upward arrow) Calcium(Upward arrow)
B
Sodium(Upward arrow) Potassium(Downward arrow) Calcium(Upward arrow)
C
Sodium(Upward arrow) Potassium(Downward arrow) Calcium(Upward arrow)
D
Sodium(Upward arrow) Potassium(Upward arrow) Calcium(Downward arrow)
High-Yield Explanation
These are medium efficacy diuretics with a primary site of action in the cortical diluting segment or the early DT (Site III). Here they inhibit Na+-Cl symport at the luminal membrane. They do not affect the corticomedullary osmotic gradient indicating lack of action at the medullary thick AscLH.  Under their action, an increased amount of Na is presented to the distal nephron, more of it is exchanges with K+, urinary K+ excretion increased in parallel to the natriuretic response. They decrease renal Ca excretion and increase Mg excretion by a direct distal tubular action. They also decrease urate excretion by the same mechanism as furosemide.

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